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i <br />� <br /> Ia <br /> I <br /> � � � � �, , /� <br /> J ' <br /> � 7�� <br /> -- i l - � �'- .S� <br /> � - .f � - � G <br /> City of Everett • <br /> Engineering Department /�''� �� <br /> Sewer Application and Permit <br /> �, . ,_ <br /> NO. �- -_ ,'_LJ � DATE <br /> Service Address Utility Account No. <br /> Billing Address ' Connection Permit Fee � <br /> City, State, Zip Connection Fee � <br /> Owner lMortgagor) Total Fee_ <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> cu:tomer <br /> Phone <br /> DESCRIPTION: Sewer District ' <br /> Lot <br /> Monthly Sewer Service <br /> Block <br /> Division or Addition_ Monthly Sewer Constr. ' <br /> Trunk I <br /> Type Permit: <br /> Lateral <br /> Remarks: '' ��y�; S 5£�✓C ' �'�'S � E iz =� <br /> Abutting Lot Line , <br /> /ls iE'C' S��Tc•N. ,'`� S E W ft i <br /> C�. !S. C 6�� C:-N$T• L.S� Lr/C. � <br /> C'���. �L • C <br /> Approved By <br /> City Enginecr . <br /> Issued By <br /> Inspection By /�� ���z"`�+"' " <br /> Date I nspected !�L �l <br /> e SEE SKETCH ATTACHED NO. 2 � ��� i <br /> i� _ � � �: <br /> --�--- <br />